{"id":1366,"date":"2024-09-02T16:06:14","date_gmt":"2024-09-02T15:06:14","guid":{"rendered":"https:\/\/wp.lancs.ac.uk\/digi-age\/?p=1366"},"modified":"2024-09-02T17:29:23","modified_gmt":"2024-09-02T16:29:23","slug":"digitising-health-and-social-care-why-a-technofix-wont-do","status":"publish","type":"post","link":"https:\/\/wp.lancs.ac.uk\/digi-age\/2024\/09\/02\/digitising-health-and-social-care-why-a-technofix-wont-do\/","title":{"rendered":"Digitising Health and Social Care \u2013 Why a Technofix Won\u2019t do"},"content":{"rendered":"

The COVID-19 pandemic has accelerated the development and speed of adoption of digital technology in <\/span>every sphere<\/span><\/a> of healthcare, including individual health management and care, population-wide health approaches, and the real-time generation, management and integration of medical data. Discussions of healthcare futures are suffused by references to \u2018digital transformations\u2019 and \u2018digital transitions\u2019, where digital technology is often looked upon as the panacea to the global \u2018crisis of care\u2019 and the challenges posed by \u2018ageing populations. This can run the danger of the widening gap between care needs and available resources being <\/span>oversimpl<\/span><\/a>ified<\/span> as a problem of <\/span>organisational deficiency, inefficiency, poor information management, outdated technology, and a shortage of staff.<\/span> Although these are very real problems and digital technology holds great potential here in improving matters, their underlying causes run the danger of remaining unaddressed by focusing solely on technology as the silver bullet.\u00a0<\/span>\u00a0<\/span><\/p>\n

The <\/span>digital transformation of the National Health Service (NHS)<\/span><\/a> in England, encompassing the digital transformation of health- <\/span>and<\/span><\/i> social care<\/span> (the latter providing people with practical assistance and personal care if they need it)<\/span>, is a case in point. <\/span>In 2023, the number of people on waiting lists for hospital treatment in England peaked at 7.8 million, while over 2.6 million people over the age of fifty were on waiting lists for social care, <\/span>\u2018left struggling to go to the toilet, eat, get dressed or wash<\/span><\/a>\u2019<\/span>. Research by Age UK showed that between 2022 and 2023, 28,655 adults over the age of sixty-five died before they reached the top of this list and received the care they needed. This equates to an average of 79 deaths a day, 550 deaths a week, and 2,388 deaths a month.\u202fTo tackle such backlogs, partly caused by the chronic staff shortages and high staff turnover besetting the sector, the digital transformation of health and social care is looked upon here <\/span>as <\/span>the <\/span>solution<\/span><\/a> to <\/span>systemic problems<\/span><\/a> besetting the healthcare system. Regarding staff shortages, for example, finding a techno-fix must seem far easier to policymakers than addressing the root causes of what professor of philosophy and politics Nancy Fraser has referred to as the \u2018<\/span>social-reproductive crisis<\/span><\/a>\u2019 caused by capitalist relations of production. Hence policies like England\u2019s 2021 white paper <\/span>People at the Heart of Care<\/span><\/a> and the <\/span>2023 Next Steps paper<\/span><\/a> look to the \u2018transformative power\u2019 of digital technology to improve the quality, safety and personalisation of care. However, this transformative power has many different sides, not all of which are necessarily positive.<\/span>\u00a0<\/span><\/p>\n

While not too long ago, <\/span>a patient\u2019s first point of contact with the National Health Service (NHS) would have been a receptionist, spoken to either in person or over the phone, today, this is likely to be the NHS app, <\/span>widely regarded as the \u2018front door\u2019 of the NHS. It has over <\/span>28 million people subscribe<\/span><\/a>rs<\/span> who use it to access health- and social care services, check <\/span>medical records, book appointments, or order prescriptions. Between October 2021 and September 2022, 1.2 billion people also visited the <\/span>NHS website<\/span><\/a>, primarily to find Covid-related information. Today, an average of twenty-three <\/span>million people access what has become Europe\u2019s largest online health information source weekly. While there are many benefits associated with these developments, digital technology, unfortunately, does not <\/span>benefit everyone equally. Many people don\u2019t know how to use it, lack the financial resources required to purchase it, have no broadband connection, or simply do not wish to make it part of their life.\u00a0<\/span>\u00a0<\/span><\/p>\n

Older adults, long known to be lesser beneficiaries of the digital economy, are particularly prone to what has come to be referred to as \u2018digital exclusion\u2019. <\/span>25% of people aged over sixty-five in the UK<\/span><\/a> do not use the Internet and lack essential digital skills<\/span>, risking access to digital health services, and, increasingly, to services like banking and shopping.\u00a0 Data from the English Longitudinal Study of Ageing (<\/span>ELSA<\/span><\/a>) shows that accessing medical appointments, support services, and consumer activities<\/span> in the UK was made worse for the digitally excluded during Covid, \u2018further exacerbating the negative health impact of the pandemic, <\/span>increasing isolation and loneliness, and social exclusion<\/span><\/a>.\u2019 The <\/span>cost-of-living crisis in the UK has since forced many more people to give up their broadband access to afford essentials. This <\/span>digital skills gap between age groups is not unique to Britain. Eurostat data collected across all EU member states in 2023 found that only 33% of those aged between fifty-five and seventy-four years of age had basic digital skills, compared to 80% of individuals aged between sixteen and twenty-four. However, older adults are not the only ones lacking digital skills.<\/span>\u00a0<\/span><\/p>\n

The <\/span>Lloyds Consumer Digital Index<\/span> of 2023 found that over <\/span>54% of working adults in the UK \u2013 including many carers \u2013 don\u2019t know how to perform the 20 tasks that industry- and government representatives have deemed essential for today’s digital workplace.\u202fLarge numbers of people are, therefore, in real danger of <\/span>being left behind<\/span><\/a> in the workplace if digitalization continues apace. This poses serious challenges, including for the health sector, where experts have warned that there is still a long way to go in order to close the digital skills gaps and bring about a successful digital transformation.\u00a0<\/span>\u00a0<\/span><\/p>\n

Digitalisation in the fields of health and social care, however, is about much more than simply changing how people access the NHS. It encompasses:<\/span>\u00a0<\/span><\/p>\n